Tag: <span>Consultants</span>

It’s almost a whole year since my Gastric Bypass surgery, and so this week I met with the Bariatric physician for a check-up.

We talked about my progress in losing weight over the last year (around 41 kg or 6 and a half stones), but mainly the conversation was about the physical, medical, mental, emotional, and psychological benefits that the weight loss has brought.

The consultant was keen to re-state that bariatric surgery is not a tool to make someone thin – it’s a tool to help make someone more healthy.

Losing all this weight has dramatically decreased my chances of getting diabetes, heart disease, fatty liver disease, and cancer. It has also helped address my hormone imbalance, and is meant to help improve men’s sexual health.

But in addition to all the great health benefits, there’s all the quality-of-life benefits. I can now exercise pain-free, and simple thinks like getting dressed on a morning are easier. It’s easier to get up off the sofa, and to walk up a flight of stairs. It’s little things like these examples that make life better when you’re a healthier weight.

Of course, one year on, I’m still an obese man. My BMI is around 35, and I still wear 2XL shirts, but I’m considerably more healthy than I used to be.

The consultant said that a good outcome of the surgery would be to have lost around 40% of excess body weight after one year. That’s lower than the 70% that I had read about on other sites. And my excess body weight loss at this point is 48%, which I’m pretty happy about. I’ve not managed to get to my goal weight – I would need to lose another 20 kg for that – but that’s fine.

He did say that I need to watch out for a couple of things in the coming year:

  1. Potential to become alcohol dependent – which I don’t think will be much of a problem for me, as I’ve all but given up drinking. I’m not completely teetotal, but I only have maybe one glass of wine about once a month.
  2. Potential to gain weight – he said to watch out for any weight gains over about 3 kg (half a stone), and to get in contact with my Bariatric team if was gaining, as they would be able to help with other forms of treatment (I’m assuming that means diet plans or drug treatments).

And unless I have any problems, then I don’t need to see the consultant again for another year.

My Story Surgery

I had an appointment with my endocrinologist today, and I was delighted to learn that my hormone levels are now back to normal!

I had been referred to the endocrinologist a couple of years ago by my oncologist when it was noted that my Testosterone levels were quite low, and I also had noticeable Gynecomastia (enlarged breasts in men).

Subsequent blood tests confirmed that my Testosterone levels were low and my Prolactin levels were high.

Hormone treatment

I had a scan done on my pituitary gland (a part of the brain which produces hormones) to check for problems, and thankfully that was fine.

I was put on medication to lower the Prolactin levels, and was then proscribed a Testosterone gel (Testogel) to apply to my skin every day. And both of these medications helped normalise my hormone levels.

However, following my bariatric surgery 10 months ago, the consultant was keen to find out if I still needed the medication – so we agreed that I would come off the meds about 3 months ago.

Anyway, so my bloods were tested last week, and the results show that both my Prolactin and Testosterone levels are now normal, which is being attributed to the 40 kg weight loss following my gastric bypass.

So naturally, I’m delighted that the hormone imbalance has corrected itself. It’s one fewer health concern to worry about, and it’s also one fewer consultant to visit!

Gynecomastia treatment

One of the known side effect in men of having high Prolactin levels is breast enlargement. However, having bigger breasts is also a side effect of being obese, so I’m not sure if my man-boobs (or ‘moobs’) are to do with my weight or the previous Prolactin levels (it may be both).

Either way, I was checking up on the treatment options for men with Gynecomastia. Basically the only effective treatment is to have liposuction, as most of the tissue in the breast is fat.

It’s classed as a cosmetic surgery, which is generally not covered by private health insurance – unless a medical case can be made for treating it.

Either way, I don’t think I’d qualify for the surgery at my current weight. I read somewhere that patients are meant to have a BMI under 25 before they are considered for Gynecomastia surgery – I’m guessing on the basis that losing weight will most likely reduce the man-boob size without surgery.

Medication Surgery

If you have private health insurance, then the price of your bariatric surgery is most likely covered by your insurer.

In recent years health insurers have recognised that an investment in weight loss surgery now can save them a lot of money in long run, as they are less likely to pay for other weight-related chronic conditions down the track. As such most health insurance companies will cover the cost of the surgery itself. To confirm cover with your insurer, quote the codes 181 and 183.

However that doesn’t mean that your weight loss surgery is entirely free. You will still have to pay for some things:

  • Your health insurance policy will most likely have an excess for being admitted to hospital as an in-patient. My charge was €75, but this varies by insurer and policy.
  • Appointments with your surgeon, dietician and other doctors before and after surgery are chargeable because you’re seeing them privately. If you have day-to-day benefits, your health insurance may also cover part of the cost of these as well. My health insurance covers 50% of the cost of visits to all hospital consultants, which I am able to claim back afterwards.

I got my gastric bypass with the St Vincent’s Private Hospital Bariatric Team in Dublin, and as of 2019 the costs to see them were:

  • Pre-assessment appointments with the physician, psychologist, dietician and surgeon – €600
  • Post-surgical care with a follow-up appointment with the surgeon, and three appointments with the dietician and/or physician, and 12 months phone and email support – €1,800

You may also need to pay for getting blood tests, and for drugs and supplements that you’ll need to take after surgery.

However these costs are certainly a lot cheaper than the €15,000 price tag of paying for the surgery yourself if you don’t have insurance!

Surgery

I started back at Slimming World 2 months ago, and in the last 8 weeks I’ve made great progress and managed to lose 2 stone in weight.

I wasn’t prepared to receive my 2 stone award today, as I was still 3½ away as of last week, and I didn’t think that was achievable. However I ended up losing 4 lbs in the week, which was amazing!

I wasn’t doing anything special this week – I was just following the food optimising plan as usual. And I guess it paid off!

In less good news, I’m feeling pretty ropey today, as I had a tooth surgically extracted yesterday, and it was a lot more traumatic than I had imagined it would be. I’m on a whole rake of drugs, but I still feel like I’m nursing a bad hangover – when I haven’t even had a drink!

It’s also sad that we’re losing our lovely consultant Caoimh at my Saturday morning SW group. It’s a real shame to see her go, but she’s still continuing to run her Tuesday and Wednesday groups. We don’t yet know who we’re getting to replace her on Saturdays mornings – but at least we’ve had assurances that the group will continue with somebody.

My Story Slimming World